1528737665 NPI number — DR. HANNAH RYAN BOGOIAN PH.D.

Table of content: DR. HANNAH RYAN BOGOIAN PH.D. (NPI 1528737665)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528737665 NPI number — DR. HANNAH RYAN BOGOIAN PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOGOIAN
Provider First Name:
HANNAH
Provider Middle Name:
RYAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MICHALAK
Provider Other First Name:
HANNAH
Provider Other Middle Name:
RYAN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1528737665
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
132 DAVID RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06422-2615
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-320-6907
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
150 OTROBANDO AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORWICH
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06360-2116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-889-7274
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/11/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X , with the licence number:  005162 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)